Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe: comparisons with general population.

PURPOSE OF REVIEW Improved virological and immunological outcomes and reduced toxicity of antiretroviral combination therapy (ART) raise the hope that life expectancy of HIV-positive persons on ART will approach that of the general population. We systematically review the literature and summarize published estimates of life expectancy of HIV-positive populations on ART. We compare their life expectancy with the life expectancy of the general or, in sub-Saharan Africa, HIV-negative populations, by time period and gender. RECENT FINDINGS Ten relevant studies were published from 2006 to 2015. Three studies were from Canada, two from European countries, three from sub-Saharan Africa and two were multicountry studies. Life expectancy increased over time in all studies and regions. Expressed as the percentage of life expectancy in the HIV-negative or general population, estimated life expectancy at age 20 years in HIV-positive people on ART ranged from 60.3% (95% CI 58.0-62.6%) in Rwanda (2008-2011) to 89.1% (95% CI 84.7-93.6%) in Canada (2008-2012). The percentage of life expectancy in the HIV-negative or general population achieved was higher in HIV-positive women than in HIV-positive men in all countries, except for Canada wherein the opposite was the case. SUMMARY Life expectancy in HIV-positive people on ART has improved worldwide in recent years, but important gaps remain compared with the general and HIV-negative population, and between regions and genders.

The illness narratives of Hispanic American women with coronary heart disease (CHD): An ethnographic approach

Purpose. To provide a descriptive representation of the illness narratives described by Hispanic American women with CHD. ^ Design. Focused ethnographic design. ^ Setting. One outpatient general medicine clinic, one nurse-managed health promotion clinic, and informants' homes in a large metropolitan city located in southeast Texas. ^ Sample. Purposeful sampling from two different sites resulted in 17 interviews being conducted with 14 informants. ^ Method. Focused ethnographic techniques were employed in the designation of participants for the study, data collection, analysis and re-presentation. Audiotaped interviews and fieldwork were transcribed verbatim and analyzed through an iterative process of data reduction, data display, drawing conclusions and verification. ^ Findings. The developing conceptual framework that emerged from the data is labeled after the overarching experience described by informants, the experience of Embodied Exhaustion. Embodied Exhaustion, as described in this study, refers to an ongoing, dynamic, indeterminate experience of mind-body exhaustion resulting from a complex constellation of biologic, psychological and social distresses occurring over the life course. The experience consists of three categories: Taking Care of Others, Wearing Down and Hurting Hearts. Two stabilizing forces were identified: Collective Self and Believing in God. ^ Conclusions. The findings of this study emphasize the importance of framing all research, theory and practice targeting Hispanic women with CHD within a sociocentric paradigm. Nursing is challenged to provide care that extends beyond the physical body of the patient to include the social context of illness, especially the family. ^

Liberalization, Ownership, and Efficiency in Indian Banking: A Nonparametric Approach

This paper empirically estimates and analyzes various efficiency scores of Indian banks during 1997-2003 using data envelopment analysis (DEA). During the 1990s India's financial sector underwent a process of gradual liberalization aimed at strengthening and improving the operational efficiency of the financial system. It is observed, none the less, that Indian banks are still not much differentiated in terms of input or output oriented technical efficiency and cost efficiency. However, they differ sharply in respect of revenue and profit efficiencies. The results provide interesting insight into the empirical correlates of efficiency scores of Indian banks. Bank size, ownership, and the fact of its being listed on the stock exchange are some of the factors that are found to have positive impact on the average profit efficiency and to some extent revenue efficiency scores are. Finally, we observe that the median efficiency scores of Indian banks in general and of bigger banks in particular have improved considerably during the post-reform period.

The Effects of Credit Risk on Dynamic Portfolio Management: A New Computational Approach

The study investigates the role of credit risk in a continuous time stochastic asset allocation model, since the traditional dynamic framework does not provide credit risk flexibility. The general model of the study extends the traditional dynamic efficiency framework by explicitly deriving the optimal value function for the infinite horizon stochastic control problem via a weighted volatility measure of market and credit risk. The model's optimal strategy was then compared to that obtained from a benchmark Markowitz-type dynamic optimization framework to determine which specification adequately reflects the optimal terminal investment returns and strategy under credit and market risks. The paper shows that an investor's optimal terminal return is lower than typically indicated under the traditional mean-variance framework during periods of elevated credit risk. Hence I conclude that, while the traditional dynamic mean-variance approach may indicate the ideal, in the presence of credit-risk it does not accurately reflect the observed optimal returns, terminal wealth and portfolio selection strategies.

The SureMath Approach to Success in Freshman Chemistry

The SureMath scheme is an alternate algebraic approach to "word problem" solving. It is used here in a freshman chemistry setting to aid students who need another method for solving chemistry problems.

Distribution of quality adjusted life expectancy: A systems approach

Statistical methods are developed which assess survival data for two attributes; (1) prolongation of life, (2) quality of life. Health state transition probabilities correspond to prolongation of life and are modeled as a discrete-time semi-Markov process. Imbedded within the sojourn time of a particular health state are the quality of life transitions. They reflect events which differentiate perceptions of pain and suffering over a fixed time period. Quality of life transition probabilities are derived from the assumptions of a simple Markov process. These probabilities depend on the health state currently occupied and the next health state to which a transition is made. Utilizing the two forms of attributes the model has the capability to estimate the distribution of expected quality adjusted life years (in addition to the distribution of expected survival times). The expected quality of life can also be estimated within the health state sojourn time making more flexible the assessment of utility preferences. The methods are demonstrated on a subset of follow-up data from the Beta Blocker Heart Attack Trial (BHAT). This model contains the structure necessary to make inferences when assessing a general survival problem with a two dimensional outcome. ^

MEASURING THE EFFECT OF ILLNESS ON THE EXPECTED REMAINING SERVICE TIME FOR THE ACTIVE DUTY ARMY: A LIFE TABLE APPROACH

A life table methodology was developed which estimates the expected remaining Army service time and the expected remaining Army sick time by years of service for the United States Army population. A measure of illness impact was defined as the ratio of expected remaining Army sick time to the expected remaining Army service time. The variances of the resulting estimators were developed on the basis of current data. The theory of partial and complete competing risks was considered for each type of decrement (death, administrative separation, and medical separation) and for the causes of sick time.^ The methodology was applied to world-wide U.S. Army data for calendar year 1978. A total of 669,493 enlisted personnel and 97,704 officers were reported on active duty as of 30 September 1978. During calendar year 1978, the Army Medical Department reported 114,647 inpatient discharges and 1,767,146 sick days. Although the methodology is completely general with respect to the definition of sick time, only sick time associated with an inpatient episode was considered in this study.^ Since the temporal measure was years of Army service, an age-adjusting process was applied to the life tables for comparative purposes. Analyses were conducted by rank (enlisted and officer), race and sex, and were based on the ratio of expected remaining Army sick time to expected remaining Army service time. Seventeen major diagnostic groups, classified by the Eighth Revision, International Classification of Diseases, Adapted for Use In The United States, were ranked according to their cumulative (across years of service) contribution to expected remaining sick time.^ The study results indicated that enlisted personnel tend to have more expected hospital-associated sick time relative to their expected Army service time than officers. Non-white officers generally have more expected sick time relative to their expected Army service time than white officers. This racial differential was not supported within the enlisted population. Females tend to have more expected sick time relative to their expected Army service time than males. This tendency remained after diagnostic groups 580-629 (Genitourinary System) and 630-678 (Pregnancy and Childbirth) were removed. Problems associated with the circulatory system, digestive system and musculoskeletal system were among the three leading causes of cumulative sick time across years of service. ^

Percepción de la calidad de vida ambiental en la localidad de General Daniel Cerri, Buenos Aires, Argentina. Propuesta de una metodología de investigación cualitativa en Geografía

El enfoque comportamental y perceptual que asume la ciencia geográfica puede resultar un aporte muy importante a la gestión ambiental del territorio. Dicho enfoque no pretende suplantar al enfoque cuantitativo, si postula su complementariedad. El presente trabajo plantea como objetivo general conocer la percepción que los habitantes de la localidad de General Daniel Cerri (Bahía Blanca, Buenos Aires, Argentina) poseen sobre su calidad de vida ambiental. La metodología empleada fue una encuesta de población representativa de la localidad en estudio, dividida en tres partes: una parte estructural -que permitirá conocer la forma en que la información que se posee sobre el lugar es percibida-; un apartado valorativo -que indicará cómo se valora el espacio en relación con las decisiones que se deberían adoptar-; y uno preferencial -orientado al análisis de las preferencias que se tienen respecto de algunos lugares

Percepción de la calidad de vida ambiental en la localidad de General Daniel Cerri, Buenos Aires, Argentina. Propuesta de una metodología de investigación cualitativa en Geografía

El enfoque comportamental y perceptual que asume la ciencia geográfica puede resultar un aporte muy importante a la gestión ambiental del territorio. Dicho enfoque no pretende suplantar al enfoque cuantitativo, si postula su complementariedad. El presente trabajo plantea como objetivo general conocer la percepción que los habitantes de la localidad de General Daniel Cerri (Bahía Blanca, Buenos Aires, Argentina) poseen sobre su calidad de vida ambiental. La metodología empleada fue una encuesta de población representativa de la localidad en estudio, dividida en tres partes: una parte estructural -que permitirá conocer la forma en que la información que se posee sobre el lugar es percibida-; un apartado valorativo -que indicará cómo se valora el espacio en relación con las decisiones que se deberían adoptar-; y uno preferencial -orientado al análisis de las preferencias que se tienen respecto de algunos lugares

Percepción de la calidad de vida ambiental en la localidad de General Daniel Cerri, Buenos Aires, Argentina. Propuesta de una metodología de investigación cualitativa en Geografía

El enfoque comportamental y perceptual que asume la ciencia geográfica puede resultar un aporte muy importante a la gestión ambiental del territorio. Dicho enfoque no pretende suplantar al enfoque cuantitativo, si postula su complementariedad. El presente trabajo plantea como objetivo general conocer la percepción que los habitantes de la localidad de General Daniel Cerri (Bahía Blanca, Buenos Aires, Argentina) poseen sobre su calidad de vida ambiental. La metodología empleada fue una encuesta de población representativa de la localidad en estudio, dividida en tres partes: una parte estructural -que permitirá conocer la forma en que la información que se posee sobre el lugar es percibida-; un apartado valorativo -que indicará cómo se valora el espacio en relación con las decisiones que se deberían adoptar-; y uno preferencial -orientado al análisis de las preferencias que se tienen respecto de algunos lugares

Australia's Foreign Economic Policy: a 'State-Society Coalition' Approach and a Historical Overview

This paper aims to explain the historical development of Australia's foreign economic policy by using an analytical framework called a 'state-society coalition' approach. This approach focuses on virtual coalitions of state and society actors that share 'belief systems' and hold similar policy ideas, goals and preferences, as basic units (policy subsystems) of policy making. Major policy changes occur when a dominant coalition is replaced by another. The paper argues that, in Australia, there have been three major state-society coalitions in the foreign economic policy issue area: 'protectionists', 'trade liberalisers' and 'optional bilateralists'. The rise and fall of these coalitions resulted in distinctive shifts of Australia's foreign economic policy in the 1980s towards unilateral and multilateral liberalisation and in the late 1990s towards bilateral trade and investment arrangements.

Case Study of Applied LIP Approach/Activities in the Philippines The Training Services Enhancement Project for Rural Life Improvement (TSEP-RLI) Experience

TSEP-RLI was a technical cooperation project jointly conducted by GOP thru DA-Agricultural Training Institute (ATI) and GOJ thru JICA aimed at institutionalizing the training program for Rural Life Improvement (RLI) at the (ATI). As expected, farmers, fisherfolk, women, youth and extension agents were provided with efficient and effective training services from ATI leading to the improvement of quality of life in the rural areas through efforts of human resource development. The ATI- Bohol was chosen as the model center where participatory trials and various activities of the project were undertaken for five years. These activities were participatory surveys and data collection of on-farm and off-farm productive activities; planning workshop for RLI; feedbacking of survey results and action plans to the community and the Local Government Units (LGUs), and signing of Memorandum of Agreement between the Project and participating LGUs. The above activities were done to facilitate the planning and development of most effective and necessary rural life improvement activities, to confirm the willingness of the people to support and participate and to formalize the partnership between the Project and the LGUs. Since the concept of rural life covers a vast range of activities, a consensus had been reached that the total aspects of rural life be grasped in three spheres, namely, Production & Livelihood (P/L), Rural Living Condition (RLC) and Community Environment (C/E). The RLI for Ubi (Yam) Growers was one of the pilot activities undertaken in two pilot barangays and the target beneficiaries were members of the Rural Improvement Club (RIC- a group of organized women) with the LGU of the Municipality of Corella as the implementing partner. During the planning workshop, the barangay residents articulated their desire to promote production and processing of ubi (sphere on P/L - as the entry point), lack of nutritious food was one of the identified problem (sphere on RLC- expansion point) and environmental degradation such as deforestation, and soil erosion was another problem articulated by the community people (sphere on C/E- expansion point). Major activities that were undertaken namely, Ubi cooking contest, cooking/processing seminar, training courses on entrepreneurial development, ubi production and storage technology, packaging and product design, human resource development and simplified bookkeeping motivated the beneficiaries as well as developed and enhanced their skills & capabilities while strengthening their associations. Their participation to the 5 ubi festivals and other related activities had brought some impacts on their economic and rural life improvement activities. The seven principles of TSEP-RLI include the participatory process, holistic approach, dialogical approach, bottom -up training needs assessment, demand-driven approach, cost sharing approach and collaborative implementation with other agencies including LGUs and the community.

Assessing agglomeration economies in the Yangzi River Delta, China : a bayesian spatial econometric approach

This paper estimates the elasticity of labor productivity with respect to employment density, a widely used measure of the agglomeration effect, in the Yangtze River Delta, China. A spatial Durbin model is presented that makes explicit the influences of spatial dependence and endogeneity bias in a very simple way. Results of Bayesian estimation using the data of the year 2009 indicate that the productivity is influenced by factors correlated with density rather than density itself and that spatial spillovers of these factors of agglomeration play a significant role. They are consistent with the findings of Ke (2010) and Artis, et al. (2011) that suggest the importance of taking into account spatial dependence and hitherto omitted variables.